Regular Monitoring Research Articles

Multiple Myeloma Presenting with Severe Back Pain: A Case Report

This study aims to highlight the diagnostic challenges and management strategies in a case of Multiple Myeloma (MM), a hematologic malignancy characterized by malignant plasma cells in the bone marrow. The case involves a 40-year-old male who presented with persistent back pain for two months, impacting his mobility. Initial physical and neurological assessments were largely unremarkable, but laboratory and radiological investigations revealed multiple osteolytic lesions suggestive of MM. Typical MM symptoms include hypercalcemia, renal dysfunction, anemia, and bone pain, though this patient did not present all the classical signs, which underscores the diagnostic complexity. A bone marrow puncture was planned for definitive diagnosis. The study emphasizes the importance of radiological evaluation in MM diagnosis and the need for prompt treatment addressing acute symptoms, such as hypercalcemia and renal insufficiency, followed by a comprehensive long-term management plan. Early oncology consultation and a multidisciplinary approach are critical for improving patient outcomes. The case demonstrates the importance of a holistic, symptom-based approach in MM management, incorporating regular monitoring and coordinated care to address the multifaceted nature of the disease.

Acceptability of dried blood spot collection by primary caregivers of Filipino patients with maple syrup urine disease (MSUD) and phenylketonuria (PKU).

MSUD and PKU require lifetime management hence, regular monitoring of amino acid levels is needed to achieve good metabolic control. Ideally, plasma amino acid analysis (PLAA) is used to monitor concentrations but is expensive and not widely available in local laboratories. The newborn screening program in the Philippines uses dried blood spot (DBS) analysis as an alternative where only trained healthcare providers are allowed to perform the collection at selected facilities. With the increasing number of patients, DBS monitoring has been noted to be delayed due to multiple factors. This issue became even more evident during the COVID-19 pandemic where high-risk patients need to travel outside for blood collection. The study used a cross-sectional study design to determine the primary caregivers' perspective on DBS self-sampling for patients with MSUD and PKU and the acceptability of the samples collected. This was done through a series of collection training, pre-/post- surveys, and 10-item questionnaire, and an in-depth 1-on-1 interview for thematic analysis. The acceptability of samples was processed and evaluated by the newborn screening laboratory. At-home DBS collection by primary caregivers was found to be acceptable. The provision of knowledge and routine collection training by the medical team aids in the increase of sample acceptability as well as a source of empowerment in being equipped to take care of their child. It is highly recommended that DBS samples collected by caregivers be considered acceptable for more time and cost-saving monitoring of the patients' metabolites. This practice also promotes timely and appropriate management which can lead to better patient health outcomes.

Renal function and risk of dementia: a Mendelian randomization study

Background The burgeoning recognition of the nexus between renal functionality and the prevalence of dementia has precipitated a surge in research endeavors. This study aims to substantiate the causal relationship between kidney functionality and dementia. Methods We utilized clinical renal function metrics from the Chronic Kidney Disease Genetics (CKDGen) Consortium and diverse dementia types (Alzheimer’s disease [AD] and vascular dementia) from the FinnGen Biobank by using Mendelian randomization analysis. At the stratum of genetic susceptibility, we tested the causal relationship between variations index in renal function and the occurrence of dementia. Inverse-variance weighted (IVW) method was the main analysis, and several supplementary analyses and sensitivity analyses were performed to test the causal estimates. Results The findings indicate a significant correlation between each unit increase in cystatin C-based estimated glomerular filtration rate (eGFR-cys) levels was significantly associated with a reduction in the incidence of late-onset Alzheimer’s disease (LOAD) (IVW: OR = 0.35, 95% CI: 0.13–0.91, p = 0.031). After adjusting for creatinine-based eGFR (eGFR-cre) and urinary albumin-to-creatinine ratio (UACR), a causal relationship was still identified between elevated levels of eGFR-cys and decreased risk of LOAD (IVW: OR: 0.08; 95% CI: 0.01–0.97, p = 0.047). Sensitivity tests demonstrated the reliability of causal estimates. Conclusions The association between renal function based on cystatin C and the augmented risk of developing AD lends support to the perspective that regular monitoring of cystatin C may be a valuable investigative biomarker.

The Shariah non-compliance (SNC) disclosure index of Islamic banks in Malaysia

Purpose This study aims to examine the Shariah non-compliance (SNC) disclosure index for all 16 Malaysian Islamic banks from 2015 to 2020. Design/methodology/approach A qualitative research methodology was adopted that included content analysis. The data were gathered from banks’ annual reports from 2015 to 2020. To achieve this, firstly, the disclosure index was developed by examining the disclosure requirements of the regulator and previous studies. The index was then used to measure the level of disclosure index for all these banks. Findings The overall average SNC disclosure index for the Islamic banks from 2015 to 2020 remained low at 0.57. However, the values were comprised of mandatory and voluntary items. For the former, the SNC disclosure index was quite high at 0.82, but for the voluntary items, the value was 0.40. Progressive improvement can be observed in the disclosure practices of the majority of the Islamic banks between 2015 and 2020; nevertheless, certain banks displayed a deterioration in their disclosure practices. Research limitations/implications This study has several limitations, including the index used, the research period and the fact that it was restricted to SNC events. Practical implications These findings add value for information users by assuring them of the accountability of Islamic banks in terms of transparency, as well as their effectiveness in managing and mitigating SNC events. Regular monitoring and strong enforcement by the regulator are essential to achieve full compliance with the stipulated requirements. Originality/value This study offers a disclosure index for analysing SNC events in depth by segregating the disclosure into mandatory and voluntary items for each Islamic bank and making recommendations for future research. In addition, it provides a broad overview of current trends in SNC and the associated issues, as well as insights for regulators and the public in terms of the transparency levels of Islamic banks in relation to SNC event disclosure.

Detection of body shape changes in obesity monitoring using image processing techniques

Body measurements are primarily made with a tape measure. In measurements taken with a tape measure, the inability to take measurements from the same part of the body each time, incorrect positioning of the tape measure, the occurrence of incorrect measurements, and the need for a person to take the measurements are significant problems in the traditional measurement method. Due to the social distancing rule that must be followed during the Covid-19 pandemic, the close contact between the person to be measured and the person taking the measurement became the starting point of this study. This study focuses on the detecting body shape changes using image processing techniques with 2D imaging. The novelty of the work is that non-contact body measurements are taken more accurately and reliably using the cosine theorem. Regular monitoring of obese patients is important in combating obesity, which is also the source of many health problems. In the monitoring of obese patients, it is necessary to determine the rate of slimming in areas where fat accumulation is intense. The error margin between the real measurements of human models and the calculated measurements was calculated as an average of ± 5.16% for waistline and an average of ± 4.58% for hip size. The cosine theorem was used instead of the ellipse formula used in the literature, and it was observed that the cosine theorem obtained results closer to reality. It is also thought that the developed system will be beneficial not only for extracting body measurements but also for extracting body measurements contactless in the textile sector. The study demonstrates the feasibility of image processing for non-contact body anthropometry and shape tracking.

Severe Combined Kidney Injury in an Hiv-Infected Patient Receiving Antiretroviral Therapy (Clinical Observation)

Kidney injury in patients infected with the human immunodeficiency virus (HIV) has a diverse spectrum. Some antiretroviral therapy (ART) drugs have nephrotoxic effects. We present a clinical case of severe combined kidney injury — chronic kidney disease (CKD) and acute kidney disease (AKD) — in a patient with HIV infection. She was on long-term treatment with a fixed-dose combination of rilpivirine, tenofovir, and emtricitabine and had normal pre-treatment renal function (estimated glomerular filtration rate 69 mL/min/1.73m2 ). There was gradual increase in blood creatinine, but the patient did not visit a nephrologist and the ART was not changed. The patient was admitted to the nephrology department two years later because she had arterial hypertension and hyperazotemia (blood creatinine 718 μmol/l). Diagnosis: chronic tubulointerstitial nephritis, CKD G5 taking into account the gradual increase in blood creatinine during long-term ART. The patient was treated with peritoneal dialysis. There was persistent decrease and stabilization of blood creatinine (210-190 μmol/l was) which indicated in AKD. The presented observation demonstrates that ART in an HIVinfected patient can lead to the development of severe combined chronic and acute kidney injury. HIV-infected patients receiving ART require regular monitoring of renal function and follow-up by a nephrologist.

Development of a droplet digital PCR assay for the detection of BK polyomavirus.

The objective of this study was to establish a more sensitive and specific diagnostic method for detecting plasma BK polyomavirus (BKPyV) DNA load in patients after renal transplantation using droplet digital polymerase chain reaction (ddPCR) and to validate the methodology. The linear range, lower limit of detection, accuracy, precision, and specificity of the detection system were evaluated by using the WHO BKPyV standard (7.2 log10 IU/mL) as a reference, in accordance with the relevant documents of the Clinical and Laboratory Standards Institute. Plasma samples were collected from 74 renal transplantation patients with urinary BKPyV-DNA levels exceeding 7 log10 copies/mL. Quantitative PCR (qPCR) and ddPCR were performed, and their diagnostic efficacy for BKPyV-DNA in the diagnosis of BK polyomavirus-associated nephropathy was evaluated using a receiver operating characteristic (ROC) curve. The coefficients of variation for the repeated detection of BKPyV standard DNA were 2.55 and 4.71 at concentrations of 6.2 and 3.2 log10 IU/mL, respectively. The linear range was 2.2-6.2 log10 IU/mL, and the lowest detection limit was 100 IU/mL. By utilizing histopathological examination of renal biopsy as the gold standard for BKPyV diagnosis, the area under the ROC curve of 74 post-transplantation plasma samples detected by the ddPCR system was found to be 0.875 (95% CI: 0.797-0.953, P < 0.01). The optimal threshold was 512.86 copies/mL, with a sensitivity of 90.0% and a specificity of 67.6%. In comparison, the area under the ROC curve for qPCR was 0.668 (95% CI: 0.583-0.752, P < 0.01), with an optimal threshold of 11,481.54 copies/mL, a sensitivity of 35.0%, and a specificity of 100.0%. Pairwise comparison (Delong test) of the ROC curves of the two systems showed a significant difference in the area under the curve, with a difference of 0.207 and a P-value <0.01. The BKPyV nucleic acid detection system, based on ddPCR, is appropriate for the regular monitoring of the BK polyomavirus, specifically in plasma samples containing low viral DNA loads while it provides the benefits of both absolute quantification and high sensitivity.IMPORTANCEIt was previously believed that droplet digital polymerase chain reaction had limitations, including high cost, limited throughput, and cumbersome operation, which hindered its widespread application in clinical practice. However, the current fully automated digital PCR platform, combined with streamlined operations, can detect 96 samples at once, and the entire process can be completed within an hour, laying a solid foundation for its extensive use.

Issues of personal data protection when using cloud technologies

It is indicated that in today’s digital world, where the amount of stored and processed data is growing at a frantic pace, issues of personal data protection are becoming increasingly important. With the proliferation of cloud technologies that allow companies and individuals to store and process information on remote servers, a new spectrum of threats to data privacy and security is emerging. The article examines the issue of personal data protection when using cloud technologies, in particular, the need to integrate legal and technological aspects to ensure comprehensive protection. The impact of international regulatory acts, such as GDPR (General Data Protection Regulation) and CCPA (California Consumer Privacy Protection Act), on cloud data protection processes is analyzed. Particular attention is paid to problems arising from differences in the legal regimes of different countries, which complicate data management at the international level. The article examines in detail modern technical solutions, such as data encryption and multi­factor authentication, which are key elements in protecting confidential information. These technologies have been found to provide a high level of protection, but also have their vulnerabilities. Based on this, it is proposed to invest in the latest technologies, in particular quantum encryption and artificial intelligence, to improve the effectiveness of data protection. Practical cases of data leaks are separately considered, which emphasize the importance of proper configuration of security systems and regular monitoring. Analysis of the results of empirical research shows the need to adapt business processes to changes in the regulatory environment and introduce new technologies to reduce risks. Based on the received data, recommendations for organizations are formulated, which include reviewing data protection policies, investing in modern technologies and training employees. The conclusions of the article emphasize the need for a comprehensive approach to ensuring the protection of personal data in cloud environments. This involves taking into account both modern technologies and current legal requirements to ensure adequate data protection and minimize possible risks.

Urine Extracellular Vesicles Size Subsets as Lupus Nephritis Biomarkers.

Systemic lupus erythematosus (SLE) is an autoimmune disorder that often leads to kidney injury, known as lupus nephritis (LN). Although renal biopsy is the primary way to diagnose LN, it is invasive and not practical for regular monitoring. As an alternative, several groups have proposed urinary extracellular vesicles (uEVs) as potential biomarkers for LN, as recent studies have shown their significance in reflecting kidney-related diseases. As a result, we developed a flow cytometry approach that allowed us to determine that LN patients exhibited a significantly higher total uEV concentration compared to SLE patients without kidney involvement. Additionally, an analysis of different-sized uEV subsets revealed that microvesicles ranging from 0.3 to 0.5 μm showed the most promise for distinguishing LN. These findings indicate that evaluating uEV concentration and size distribution could be a valuable diagnostic and monitoring tool for LN, pending further validation in more comprehensive studies.

A Surveillance Study of Culturable and Antimicrobial-Resistant Bacteria in Two Urban WWTPs in Northern Spain.

Wastewater treatment plants (WWTPs) are hotspots for the spread of antimicrobial resistance into the environment. This study aimed to estimate the proportion of clinically relevant antimicrobial-resistant bacteria in two Spanish urban WWTPs, located in the region of La Rioja (Spain); Methods: Ninety-four samples (48 water/46 sludge) were collected and streaked on ten different selective media, in order to recover the culturable bacterial diversity with relevant resistance phenotypes: Extended-Spectrum β-Lactamase-producing Escherichia coli/Klebsiella pneumoniae (ESBL-Ec/Kp), Carbapenem-resistant Enterobacteriaceae (CR-E), Methicillin-resistant Staphylococcus aureus (MRSA), and Vancomycin-resistant Enterococcus faecium/faecalis (VR-E. faecium/faecalis). Isolates were identified by MALDI-TOF and were tested for antimicrobial susceptibility using the disk diffusion method. The confirmation of ESBL production was performed by the double-disk test; Results: A total of 914 isolates were recovered (31 genera and 90 species). Isolates with clinically relevant resistance phenotypes such as ESBL-Ec/Kp and CR-E were recovered in the effluent (0.4 × 100-4.8 × 101 CFU/mL) and organic amendment samples (1.0-101-6.0 × 102 CFU/mL), which are discharged to surface waters/agricultural fields. We reported the presence of VR-E. faecium in non-treated sludge and in the digested sludge samples (1.3 × 101-1 × 103 CFU/mL). MRSA was also recovered, but only in low abundance in the effluent (0.2 × 101 CFU/mL); Conclusions: This study highlights the need for improved wastewater technologies and stricter regulations on the use of amendment sludge in agriculture. In addition, regular monitoring and surveillance of WWTPs are critical for early detection and the mitigation of risks associated with the spread of antimicrobial resistance.

Risk of cellular or antibody-mediated rejection in pediatric kidney transplant recipients with BK polyomavirus replication-an international CERTAIN registry study.

In kidney transplant recipients (KTR), BK polyomavirus-associated nephropathy (BKPyVAN) is a major cause of graft loss. To facilitate the clearance of BKPyV-DNAemia, reduction of immunosuppression is currently the treatment of choice but may increase the risk of graft rejection. This international CERTAIN study was designed to determine the risk of alloimmune response and graft dysfunction associated with immunosuppression reduction for BKPyV treatment in 195 pediatric KTR. BKPyV-DNAemia was associated with a more than twofold increased risk of late T cell-mediated rejection (TCMR) (HR 2.22, p = 0.024), of de novo donor-specific HLA antibodies (dnDSA) and/or antibody-mediated rejection (ABMR) (HR 2.64, p = 0.002), and of graft function deterioration (HR 2.73, p = 0.001). Additional independent risk factors for dnDSA/ABMR development were a higher HLA mismatch (HR 2.72, p = 0.006) and re-transplantation (HR 6.40, p = 0.000). Other independent predictors of graft function deterioration were TCMR (HR 3.98, p = 0.003), higher donor age (HR 1.03, p = 0.020), and re-transplantation (HR 3.56, p = 0.013). These data indicate that reduction of immunosuppression for BKPyV-DNAemia management is associated with increased alloimmune response in pediatric KTR. Therefore, regular dnDSA screening and close monitoring of graft function in case of BKPyV-DNAemia followed by subsequent reduction of immunosuppressive therapy are recommended.

Acute Effect of Three Aerobic Exercise Intensities on Glomerular Filtration Rate in Healthy Older Adults.

To assess the immediate effects of three aerobic exercise intensities on the estimated glomerular filtration rate (eGFR) in healthy, sedentary older adults. Eighteen healthy, sedentary older adults (ten men and eight women) voluntarily participated in this study. The participants underwent three standardized aerobic exercise tests (100%, 80%, and 60% of the maximal heart rate) on a bicycle ergometer. Blood samples were collected to determine cholesterol, triacylglycerols, glucose, serum creatinine (Cr), Cystatin C (CysC) concentrations, and eGFR. eGFR and serum concentrations of Cr and CysC were not modified at any exercise intensity. There was a negative correlation between blood total cholesterol vs. eGFR (R = -0.512, R = -0.582, R = -0.531; p < 0.05) at rest, 60%, and 100% of the maximal heart rate, respectively. In addition, a negative correlation existed for age vs. eGFR at 60% of the maximal heart rate (R = -0.516; p < 0.05). Short-duration aerobic exercise of low, moderate, and vigorous intensity did not significantly affect eGFR and is considered safe for kidney function in healthy, sedentary older adults. However, regular monitoring of kidney function in older people engaged in moderate- and high-intensity exercise is advised.

Low bone mineral density and its influencing factors in spinal muscular atrophy without disease-modifying treatment: a single-centre cross-sectional study

BackgroundChildren with spinal muscular atrophy (SMA) are at risk of low bone mineral density (BMD) and bone fragility. This study aims to assess lumbar spine BMD measured by quantitative computed tomography (QCT) and investigate influencing factors of low BMD in children with SMA without disease-modifying treatment.MethodsDemographic data, laboratory parameters, QCT data, and data on spinal radiographs were collected. A linear regression model was carried out to explore the correlations between BMD and its related factors.ResultsSixty-six patients with SMA who had complete records between July 2017 and July 2023 were analyzed, with SMA with a mean age of 5.4 years (range, 2.4–9.7 years), including type 1 in 14, type 2 in 37, and type 3 in 15. 28.8% of patients (19/66) were diagnosed with low BMD (Z-scores ≤ − 2), and the mean BMD Z-scores on QCT was − 1.5 ± 1.0. In our model, BMD Z-scores was associated with age (β=-0.153, p = 0.001). SMA phenotype and serum bone metabolism markers, such as serum phosphorus (P), alkaline phosphatase (ALP) and 25-Hydroxyvitamin D (25-OH-D) levels did not independently predict low BMD. ROC analysis showed that the age ≥ 6.3 years predicts a Z-scores ≤ -2.0 with a sensitivity of 68.4% and a specificity of 68.1%.ConclusionsLow BMD were highly prevalent in children with SMA without disease-modifying treatment in our centre. Regular monitoring of BMD is necessary for all types of SMA children, especially those aged ≥ 6.3 years.

Effect of continuous inhaled corticosteroids on glycated hemoglobin in asthmatic children: a pilot study

BackgroundAsthma is a prevalent chronic disease with significant impact on patients, families, and communities. Inhaled corticosteroids (ICS) are the mainstay of treatment for persistent and uncontrolled asthma. However, concerns remain about the potential adverse effects of ICS, including HbA1c level. This study aims to evaluate the influence of ICS on Hemoglobin A1c (HbA1c) levels in children with bronchial asthma.MethodsThis prospective cohort study included 48 pediatric asthma patients aged 2 to 15 years who had been using ICS for at least 6 months. Comprehensive clinical assessments and measurements of HbA1c levels were conducted at the start of recruitment and after 6 months of ICS use. The types and doses of ICS used followed the guidelines provided by the Global Initiative for Asthma (GINA).ResultsThe initial HbA1c levels ranged from 4.46 to 6.11, with a mean of 5.32 ± 0.35. Three patients (6.3%) had persistent prediabetes status after 6 months. There was no significant relationship between glycemic status and the characteristics of ICS. The duration of ICS therapy and the doses used did not significantly affect HbA1c levels. A weak positive correlation was observed between initial and subsequent HbA1c levels.ConclusionThe study found no significant difference in HbA1c levels among asthmatic children using ICS after six months of treatment. Additionally, there was no significant difference in HbA1c levels between patients using different types of ICS. Regular monitoring of HbA1c levels is recommended, particularly for children on high doses or prolonged use of inhaled Fluticasone.

Impact of occupational lead exposure on the comprehensive health status of gas cutter workers

BackgroundOccupational exposure to hazardous substances, particularly in involving metal cutting and welding industries, poses critical public health concern. This study assesses the health status of gas cutter workers, focusing on Pb exposure. MethodIn this cross-sectional study, 40 participants with BLL ≥20 μg/dL were recruited from workers engaged in oxy-acetylene metal cutting. These workers were compared to an age-, sex-, and sociodemographic-matched control group (n = 42) from the same workplace. Health assessments including routine clinical and laboratory investigations along with BLL, and markers of calcium homeostasis were carried out. ResultsGas cutters exhibited significantly higher mean systolic BP and elevated SGOT levels, with similar prevalence of respiratory symptoms and musculoskeletal disorders in both groups. No significant differences were found in most hematological, liver, and renal parameters. However, gas cutters had significantly higher PTH levels and lower serum vitamin D levels. Pulmonary function tests indicated significantly reduced FVC, FEV1, FEV1/FVC ratio, FEF25-75 %, and PEFR in gas cutters, as well as markedly higher CRP levels. ConclusionGas cutters experience significant health impacts compared to controls, including elevated systolic BP, impaired pulmonary function, and disturbance in calcium homeostasis due to occupational Pb exposure. Higher CRP levels suggest notable inflammatory responses. These findings highlight the urgent need for targeted interventions and regular monitoring to mitigate health risks associated with Pb exposure among gas cutter workers.

Perception of the Capixaba population regarding the use and benefits of antidepressants and anxiolytics

Depression is a routine disorder characterized by at least two weeks of loss of pleasure, mood, and interest in basic daily activities. Treatment involves psychotherapy, lifestyle changes, and medication therapy with antidepressants. These medications increase the availability of neurotransmitters in the central nervous system through different mechanisms of action, such as Monoamine Oxidase Inhibitors, Tricyclic Antidepressants, Selective Serotonin Reuptake Inhibitors, and Atypicals. Studies indicate that, after the pandemic, mental health issues such as anxiety and depression became more frequent in society, leading to greater use of antidepressants, especially clonazepam, sertraline, and amitriptyline. This project aims to investigate this usage, focusing on the benefits and drawbacks from the user’s perspective. To this end, it was submitted to the Ethics and Human Research Council of UNESC, with a bibliographic review conducted in the PubMed, Lilacs, and Scielo databases during the approval period. After approval, the research was conducted through structured questionnaires, made available online to the Capixaba society. The study evaluated the rate of use of these psychotropic drugs in the region, the benefits, risks, and behaviors regarding the use of antidepressants and anxiolytics from the perspective of patients. The use of psychotropic drugs by the population can be satisfactory for treating mental disorders, but it is essential that these medications are used with caution and under the guidance of a healthcare professional. Regular monitoring helps to manage adverse effects, ensure the medication is working properly, and prevent long-term medication-related problems.

MeerKAT Observations of Procyon at 815.5 MHz

We have conducted observations of the nearby (11.46 ly) star system Procyon, using MeerKAT’s UHF (544–1087 MHz) receivers. We produce full-Stokes time and frequency integrated continuum images, as well as total intensity time series imaging at 8 s cadence, and full-Stokes vector-averaged dynamic spectra from the visibilities in order to search for transient activity such as flaring events. We detect no significant radio emission from the system, and estimate an upper limit on the circular polarization fraction of 65% (3σ confidence level). A comparison with previous Very Large Array observations places a 3σ lower limit on the spectral index between 815.5 and 8400 MHz of 0.26, however long-term significant variability over the last 33 yr cannot be ruled out without further, regular radio monitoring of the system.

Spatial variation in physicochemical water quality parameters associated with Rice farming in the Dakalt Branch Canal, Kafrelsheikh governorate, Egypt

AbstractThe inappropriate use of chemical fertilizers and pesticides in rice farming has been identified as a significant source of pollution in the aquatic environments. The declining water quality has been a cause of concern for the riparian communities owing to ill health associated with the usage of contaminated water from lotic systems draining such rice‐growing areas and its potential to cause lethal and sublethal effects on aquatic organisms. The spatial variation of selected water quality parameters was assessed using multivariate techniques. Data from three sampling stations, collected in triplicates, were analyzed to understand the effects of rice farming practices on the Dakalt Branch Canal's water quality. Eleven physicochemical parameters were measured in situ with a portable multimeter, while nutrients and other chemical parameters were determined following the standard procedures outlined in the American Public Health Association using the UV/Visible spectrophotometer. One‐way ANOVA was used to establish whether or not there were significant differences among means of various parameters. The findings revealed considerable spatial variability in the means for nearly all water quality parameters (p &lt; 0.05). The Water Quality Index revealed that all the sampling stations were polluted with indices of more than 100. We conclude that poor rice management practices are responsible for the observed pollution of the River Nile and potentially lethal and sublethal effects on aquatic organisms and human health. We therefore recommend regular monitoring of the water quality of the Dakalt Branch Canal and that the relevant stakeholders, including farmers, embrace Best Management Practices, especially when applying pesticides and fertilizers.

Practical application of teledentistry in orthodontic patients during the Covid-19 pandemic

Aim: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) or COVID-19 infection has been an unusual plummet in dentistry. Various measures were adopted to slow or halt the spread of COVID-19. Many countries suspended activities that are deemed “non-essential.” Several dental procedures fall into this category, and only emergencies that cannot be postponed are still allowed. Therefore, followup visits for active orthodontic treatment should be treated with special new standard precautions. This review aims to reduce orthodontic treatment appointments by providing an overview of the available methods and their purpose in patient monitoring, i.e., teleorthodontic. Methods: A total of 5 articles demonstrating the practical application of teledentistry including teleorthodontic were included. Result: Most emergencies can be handled via teleorthodontics, which can reassure and follow patients from afar. Teleorthodontics achieved its goal of reducing patient visits while keeping regular monitoring without sacrificing results. Conclusion: Teleorthodontics can handle most emergencies assist and follow up patients remotely while at their homes. It can reduce the number of patient visits while maintaining regular monitoring without compromising the results of orthodontics treatment. These findings still need further development in efficacy, cost-effectiveness, and long-term outcomes, but we believe teleorthodontics plays an essential role during the COVID-19 outbreaks.

Manifestations and outcomes of digestive tract involvement in adult Langerhans cell histiocytosis.

Langerhans cell histiocytosis (LCH) is a heterogeneous histiocytosis characterized by proliferation of Langerhans cells. While less common, manifestations of digestive tract involvement in LCH remain largely unrevealed. We conducted a retrospective analysis of demographics, clinical, endoscopic, genetic and follow-up data from 13 adult patients with pathologically confirmed gastrointestinal involvement of LCH (LCH-GI), in a single-center cohort of 465 patients. Digestive tract involvement was observed in 2.80% of LCH patients. At LCH-GI diagnosis, 7 patients (53.8%) had unifocal lesions, and 6 patients (46.2%) had multisystem disease. 6 patients (46.2%) experienced no gastrointestinal symptoms at LCH-GI onset, while others were symptomatic. Stomach was most commonly affected (61.5%), followed by esophagus (23.1%), colon (7.7%) and anus (7.7%). Endoscopic findings varied among 12 patients, including submucosal bulge (8 patients, 66.7%) and non-bulging lesions (4 patients, 33.3%) such as erosions, coarse granular mucosa, and regional abnormal coloration. Among 8 patients with genetic analysis, BRAFV600E mutation was detected in 5 patients (62.5%). The estimated 1-year overall survival rate was 91.7%. Progression-free survival of patients with submucosal bulges under endoscopy was significantly better than those with non-bulging lesions. This study presents 13 cases of LCH with digestive tract involvement. We emphasize the importance of endoscopy and biopsy for pathological examination of lesions such as submucosal bulges and erosions under endoscopy to assist in early detection of LCH. Comprehensive systemic assessment and regular endoscopic monitoring are essential in patient management. Treatment should be individualized with dynamic adjustments during follow-up.